LAKE COUNTY ROWING ASSOCIATION LAKE YOUTH CREW REGISTRATION Welcome! The mission of LCRA Youth Crew is to promote the sport of rowing among Lake County high school teens and create competitive studentathletes with a spirit of honor, self-respect, good sportsmanship, teamwork, moral integrity, healthy habits and strong character. We look forward to working with you to provide a fun, safe and competitive environment to learn and grow. Rowers and Parents- Here is what you need to know to get started: Registration check list: In order for student-athletes to join LCRA and participate in club activities this check list must be completed in full before any participation! Read the youth team information Join online by sending an email to info@lakecountyrowing.org Fill out rower information form Read the Team Policies and Procedures and sign the Team Policies and Procedures signature page Complete and sign the Emergency Treatment Authorization Complete and sign the LCRA Release, Waiver and Notification of Risk form Complete and sign US Rowing Waiver Copy of insurance card front and back Complete and sign the Sports Physical form Turn in required forms with the non-refundable registration fee of $100. T-Shirt and Uniform Fee Season s Race Fees of $. For questions please contact Karen / Youth chair at info@lakecountyrowing.org 1
Because LCRA Crew is an off-campus club sport, all communications will be via email and Google Calendar, and it is vital that rowers and parents check daily for updates and important information. Any change of email address or phone numbers should be communicated immediately. Please like us on FaceBook: Lake County Rowing Association Practice schedule- Will be posted by season: Spring - January, February, March, April, May Summer - June, July, August Fall - September, October, November, December Practice location- Our temporary water practice location is situated on an empty lot between two residences- 10648 Lake Minneola Shores, Clermont FL 34711, approx. 200 yards west of the The Palisades community water access. Land practices will be held at Waterfront Park. The City of Clermont and Lake County are providing LCRA with a Boathouse coming late fall 2014. All rowers must have the following items at practice: Water shoes Sneakers and dry socks A small towel/rag (To wipe down boat and boat tracks after each row) 32 oz Refillable WATER a refillable personal water bottle which cannot be shared with other rowers FINANCIAL COMMITMENT Each student-athlete must become a member of LCRA and has a financial obligation to the club. LCRA is an all-volunteer organization with the exception of our coaching staff Fees cover: Club Membership to US Rowing Use of boats, oars and equipment Coaching fees Season s Regatta fees. (Each season the c oach will determine quantity and location of regattas. Your registration fee covers registration at two fall regattas- (if additional races are added additional fees may apply) Travel expenses are NOT INCLUDED 2
Uni-Suit (uniform) and Team T-Shirt Florida Scholastic Rowing Association membership (needed to race in Florida) LCRA Administrative expenses (insurance and operating expenses.) LCRA CREW TEAM POLICIES 1. Student-Athletes are expected to attend ALL scheduled practices. LCRA understands that many student athletes may be involved in school or family activities and may have conflicts from time to time. Athletes must contact the coach before each anticipated absence. Persistent unexcused absences may result in exclusion from regatta or rowing activities. 2. Please be punctual and discuss conflicts with coaches at the beginning of the rowing season. 3. Rowers are expected to abide by the same rules of conduct set forth by the Florida High School Athletic Association (FHSAA) and repres ent LCRA in a sportsmanlike and appropriate manner at practice and all events. 4. Maintain a positive attitude at events and practices. 5. Refrain from using any foul language or obscene gestures 6. Treat Teammates, adult volunteers and coaching staff with respect 7. Treat all LCRA equipment with care 8. Share you positive comments on LCRA Facebook page. Any other posting on the web regarding LCRA must be approved by the coaching staff. 9. Act with integrity, respect, trust and honesty. If team members are not conducting themselves in a manor expected by LCRA, Please speak to a coach or the Crew Chairman. 10. The use of tobacco, alcohol and non-prescription drugs is strictly prohibited. 11. Wear appropriate clothing for sporting activities. 12. Follow directions from coaches and regatta officials. Safety is always the first priority. 13. Rowers and Coxswains understand that to remain eligible for National Collegiate Athletic Association (NCAA), US Rowing Association or Florida Scholastic Rowing Association, Scholarships he/she cannot accept any form of payment to be on the team. Parents and student-athletes should be familiar with the above policies. Please understand that failure to follow these policies may result in a suspension or dismissal from the team 3
LCRA CREW PARENT POLICIES 1. Support the LCRA Crew Team Policies by practicing good sportsmanship and treating all student-athletes, LCRA volunteers and coaching staff with respect. 2. Volunteer regularly Parent participation is mandatory and it is expected that parents will help out with variety of roles. 3. Maintain a healthful environment at regattas by refraining from drug, alcohol and tobacco use. 4. Understand that Youth Crew practice times are for student athletes. Adults may join the Masters Crew if interested. For masters info contact wendy@lakecountyrowing.org Payments Club Fees are paid on a season basis - Spring, Summer, Fall Seasons Coaches cannot accept unsealed payments. In order for student-athletes to participate, payments must be kept up-to-date. Dues are non-refundable. Dues are payable at the beginning of each season and can be paid in cash or check, Payable to: Lake County Rowing Association or (LCRA) 1. Given to: Wendy Burkett, Karen Dorr, Betty Green 2. Drop off: First Green Bank Clermont (Please be sure to NOTE: ATHLETES NAME in memo section all cash must be in a sealed envelope with athletes name and a note regarding what the payment is for) 3. Mailed to: LCRA, PO Box 120173, Clermont, FL 34712 Contact Changes Please notify us of any changes to your contact information immediately. Updates and communication can be email to wendy@lakecountyrowing.org TeamSnap will reflect all changes and is LCRA s primary communication tool. Please make sure emails form TeamSnap are not going to your junk mail. LCRA would like to offer fundraising opportunities and is in need of a Youth Crew parent volunteer to lead a youth fundraising committee. Please see Debbie Kiely info@lakecountyrowing.org if you are interested. 4
LAKE COUNTY ROWING ASSOCIATION YOUTH CREW Date: ROWER INFORMATION: First Name: Last Name: Address: City: Zip: Athletes Cell Phone: Home Phone: E-mail: Lives with: Date of Birth: Age: Height: Weight: Gender M / F School Name: Grade: Special Needs/Medical Conditions: Parent/Legal Guardian Information #1 / Legal Guardian s Name: Occupation: Address: Home Phone: Work Phone: Parent Cell Phone: E-mail: (required) #2 /Legal Guardian s Name: Occupation: Address: (indicate if same as above) Home Phone: Work Phone: Parent Cell Phone: E-mail: (required) Changes: Please notify us of any changes to the above information. Updates can be emailed to wendy@lakecountyrowing.org. Billing statements Payment information will be communicated via email. Reliable email addresses are required. Please make sure emails from this service are not going to your junk mail. Contact wendy@lakecountyrowing.org for questions. 5
LCRA TEAM POLICIES AND PROCEDURES ACKNOWLEDGEMENT STATEMENT (Signature Page) I have read and understand the policies and procedures for being a member of the LCRA Youth Crew and Parents and I agree to abide by them. I understand that failure to adhere to these policies may result in my suspension or dismissal from the team. STATEMENT OF SWIMMING COMPETENCY I understand that all team members will be tested to verify that they are able to handle themselves safely in the event of a water emergency. I hereby certify that my son/daughter,, is a capable swimmer. STATEMENT OF FINANCIAL COMMITMENT I have read and understand the financial obligations for my son/daughter to be a member of the (School Year) LCRA Youth Crew. I agree to be responsible for this financial commitment. STATEMENT OF PHOTO CONSENT I understand that photos of my rower participating in LCRA activities may be used for LCRA promotional material. I allow for photos of my rower to be used in appropriate printed or online LCRA marketing materials. Student name: (print) Date: Student Signature: Parent/Guardian Name: (print) Date: Parent/Guardian Signature: 6
EMERGENCY MEDICAL TREATMENT AUTHORIZATION Student-athlete s Legal Name: Grade: DOB: Date of last tetanus shot: My child is taking the following prescribed medications: My child has/had the following allergies: Please identify any serious injuries, illnesses or health conditions you child has had/has: Alternate family member/friend to contact in case of an emergency: Name: Phone: Insurance Information Primary Care Doctor Name: Phone: Primary Insurance Company: Policy #/ID: (Copy of insurance card front and back) Insurance Company Address: Photocopy of both sides of their insurance card with this emergency treatment authorization. You understand if a parent, guardian or student-athlete falsifies any signature or information on this emergency treatment authorization, the student will be declared ineligible to participate in any LCRA activity for one full calendar year from disclosure date. You further give permission and authorize the officers, board members, volunteers, coaches, school staff or other representative of Lake County Rowing Association (LCRA), as agent(s) for the undersigned to consent to any x-ray examination, and the anesthetic, medical or surgical diagnosis or treatment, and hospital care which is deemed advisable by, and is to be rendered under general or special supervision of any physician and surgeon licensed under the provisions of the Medical Practice Act on the medical staff of any hospital, whether such diagnosis or treatment is rendered at the office of said physician, or said hospital. It is understood that this authorization is given in advance of any specific diagnosis, treatment or agent(s) to give specific consent to any and all such diagnosis, treatment or hospital care which physician, meeting the requirements of this authorization, may, in the exercise of his/her best judgment deem advisable. I further agree to hold said agents, LCRA, its officers, volunteers, board members, school staff and coaches harmless in the administration of such assistance. I hereby authorize any hospital, which provided treatment to the above named minor, to surrender physical custody of such minor to my above named agent(s) upon completion of treatment. These authorizations will remain in effect for one (1) year from date of hereof unless revoked in writing and delivered to said agent(s). I hereby acknowledge and certify that I have read the emergency medical treatment document, that I understand and agree with its terms Florida Statutes (92.525) Under penalties of perjury, I declare that I have read the foregoing and that the facts in it are true. I agree to be bound by its terms and I have reviewed and explained the notice with my child. Date: Signature of Parent/Legal Guardian Print Name of Parent/Legal Guardian 7
LCRA Release, Waiver and Notification of Risk You understand if a parent, guardian or student-athlete falsifies any signature or information on this emergency treatment authorization, the student will be declared ineligible to participate in any LCRA activity for one full calendar year from disclosure date. You further give permission and authorize the officers, board members, volunteers, coaches, school staff or other representative of Lake County Rowing Association (LCRA), as agent(s) for the undersigned to consent to any x-ray examination, and the anesthetic, medical or surgical diagnosis or treatment, and hospital care which is deemed advisable by, and is to be rendered under general or special supervision of any physician and surgeon licensed under the provisions of the Medical Practice Act on the medical staff of any hospital, whether such diagnosis or treatment is rendered at the office of said physician, or said hospital. It is understood that this authorization is given in advance of any specific diagnosis, treatment or agent(s) to give specific consent to any and all such diagnosis, treatment or hospital care which physician, meeting the requirements of this authorization, may, in the exercise of his/her best judgment deem advisable. I further agree to hold said agents, LCRA, its officers, volunteers, board members, school staff and coaches harmless in the administration of such assistance. I hereby authorize any hospital, which provided treatment to the above named minor, to surrender physical custody of such minor to my above named agent(s) upon completion of treatment. These authorizations will remain in effect for one (1) year from date of hereof unless revoked in writing and delivered to said agent(s). I hereby acknowledge and certify that I have read the emergency medical treatment document, that I understand and agree with its terms Florida Statutes (92.525) Under penalties of perjury, I declare that I have read the foregoing and that the facts in it are true. I agree to be bound by its terms and I have reviewed and explained the notice with my child. Date: Signature of Parent/Legal Guardian Print Name of Parent/Legal Guardian Street Address: City: State: Zip: LCRA RELEASE, WAIVER AND NOTIFICATION OF RISK IN CONSIDERATION of being given the opportunity to participate in any Lake County Rowing Association. Inc. ("Club") activities ("Activity") until the end of this school year and the ensuing summer programs for the Club, I, for myself, my personal representatives, assigns, heirs, and next of kin: 1. ACKNOWLEDGE, agree and represent that I understand the nature of Rowing Activities, both on water and land based, and that I am qualified, in good health, can swim adequately, and am in proper physical condition to participate in such Activity. 2. FULLY UNDERSTAND that: (a.); ROWING ACTIVITIES INVOLVE RISKS AND DANGERS of serious bodily injury, including permanent disability, paralysis and death including specifically, but without limitation, that on Lake Minneola and at Water Front Park where the Club holds practices and regattas, and other Activity, there are alligators, 8
snakes and other wild animals in or about the lake, and that it is possible for rowing and other boats to be overturned or flipped in the water causing rowers to be plunged into the water ('Risks"); (b.) these Risks and dangers may be cau sed by my own actions, or inactions, the actions or inactions of others participating in the Activity, the condition in which the Activity takes place, the weather, or the negligence of the Releases names below; (c.); there may be other risks and social and economic losses either not known to me or not readily foreseeable at this time; and I FULLY ACCEPT AND ASSUME ALL SUCH RISKS AND ALL RESPONSIBILITY FOR LOSSES, COSTS, AND DAMAGES I incur as a result of my participation in the Activity. 3. AGREE AND WARRANT that I will examine and inspect each Activity in which I take part as a member of the Club and that, if I observe any condition which I consider to be unacceptably hazardous or dangerous, I will notify the proper authority in charge of the Activity and will refuse to take part in the Activity until the condition has been corrected to my satisfaction. 4. HEREBY RELEASE, discharge, and covenant not to sue, USRowing, the Club, Lake County Public Schools, The City Of Clermont, their administrators, directors, board members, coaches, agents, officers, volunteers and employees, other participating regatta organizers, any sponsors, advertisers, and if applicable, owners and lessors of premises, on which the Activity takes place (each considered one of the Releases herein) from all liability, claims, demands, losses or damages on my account caused or alleged to be caused in whole or in part by the negligence of the Releasees or otherwise, including, without limitation, negligent rescue operations; and I further agree that if, despite this release and waiver of liability, assumption of risk, and indemnity agreement, I, or anyone on my behalf, makes a claim against any of the Releasees, I WILL INDEMNIFY, SAVE AND HOLD HARMLESS each of the Releasees, from any litigation's expenses, attorney fees, loss, liability, damage, or cost which any may incur as a result of such claim. I have read this agreement, fully understand its terms, understand that I have given up substantial rights by signing it and have signed it freely and without any inducement or assurance of any nature and intend it be a complete and unconditional release of all liability to the greatest extent allowed by law and agree that if any portion of this agreement is held to be invalid, the balance, notwithstanding, shall continue in full force and effect. Printed Name of Athlete Participant: Signature Printed Name of Parent/Guardian: Signature 9
PARENTAL CONSENT AND I, the minor's parent and/or legal guardian, have read the language above and understand it, understand the nature of rowing activities, the nature of Lake Minneola and its environs as aforesaid, and the minor's experience and capabilities and believe the minor to be qualified to participate in such Activity. I hereby release, discharge, covenant not to sue, and AGREE TO the aforesaid release and waiver on behalf of the minor, and agree to INDEMNIFY AND SAVE AND HOLD HARMLESS each of the Releasees from all liability, claims, demands, losses, or damages on the minor's account caused or alleged to be caused in whole or part as a result of the aforesaid Activity or by the operations of the Club, and further agree that if, despite this release, I, the minor, or anyone on the minor's behalf makes a claim against any of the above Releasees, I WILL INDEMNIFY, SAVE, AND HOLD HARMLESS each of the Releasees from any litigation expenses, attorney fees, loss liability, damage, or cost any may incur as the result of any such claim. Printed Name of Parent/Guardian: Signature Parent/Guardian Signature (only if participant is under the age of 18) Date 10
Lake County Rowing Association WAIVER OF LIABILITY FORM In consideration of being given the opportunity to participate in the programs and activities of the Lake County Rowing Association referred to as LCRA and The City of Clermont, for myself, my personal representatives, assigns, heirs, and next of kin: 1. I ACKNOWLEDGE, agree, and represent that I understand the nature of rowing, dragon boat and related activities, both onthe water and land-based, and that I am qualified, in good health, and in proper physical condition to participate. 2. I FULLY UNDERSTAND that: ROWING RELATED ACTIVITIES INVOLVE RISKS AND DANGERS of serious bodily injury, including permanent disability, paralysis, and death ( risks ); these risks may be caused by my own actions, or inactions, the actions, or inactions, of others participating in the programs and activities of LCRA, the conditions in which the programs and activities take place, or the negligence of the releasees named below; there may be other risks and social and economic losses either not known to me or not foreseeable at this time; and I FULLY ACCEPT AND ASSUME ALL SUCH RISKS AND ALL RESPONSIBILITY FOR LOSSES, COSTS, AND DAMAGES I incur as a result of my participation in LCRA programs and activities. LCRA will not be held responsible or liable for any loss or damage to any equipment owned or leased by club members. It shall be the member s responsibility to provide adequate insurance to cover equipment in the event of loss or damage. Members storing and/or using privately owned or leased equipment shall be liable for any and all damages incurred as a result of moving equipment around, into and out of the boathouse, LCRA s property, the property of City of Minneola and all related damage or accidents while in the act of rowing. 3. I AGREE AND WARRANT that I shall be cautious and make every effort to safely move equipment between the boathouse, city property and Lake Minneola and report to the LCRA Administrative Staff any damage created by myself to my equipment or to LCRA s equipment or equipment owned or leased by LCRA members. 4. I HEREBY RELEASE, discharge, and covenant not to hold liable nor sue LCRA, its administrators, directors, agents, officers volunteers and employees, and other participants, club organizers, any sponsors, advertisers, and, if applicable, owners and lessors of premises on which LCRA activities and programs take place (each considered one of the releasees herein) from all liability, claims, demands, losses, or damages on my account caused or alleged to be caused in whole or in part by the negligence of the releasees or otherwise, including negligent rescue operations; and. I further agree that if, despite this release waiver of liability, assumption of risk, and indemnity agreement, I, or anyone on my behalf, makes a claim against any of the releasees, I WILL INDEMNIFY, SAVE, AND HOLD HARMLESS each of the releasees from any litigation expenses, attorney fees, loss liability, damages, or costs which they may incur as a result of such claim. I have read this agreement, fully understand its terms, understand that I have given up substantial rights by signing it and have signed it freely and without any inducement or assurance of any nature and intend it to be a complete and unconditional release of all liability to the greatest extent allowed by law and agree that if any portion of this agreement is held to be invalid, the balance, notwithstanding, shall continue in full force. If applicant is under the age of 18, a parent or legal guardian must sign this form. Name: Address: City: State: ZIP Phone: Work Phone: Email: Signature: Date Signed: LOCAL EMERGENCY CONTACT NAME: PHONE: By my signature below, I hereby certify that I have sufficient ability to swim to shore in the event of an accident including (without limitation) the capsize of any boat and its ineffectiveness as a floatation device, whether in a lake, river or otherwise. 11